Individual
MRS. HEIDI MOONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1504 BARKSDALE BLVD, BOSSIER CITY, LA 71111-4602
(318) 222-4299
Mailing address
1504 BARKSDALE BLVD, BOSSIER CITY, LA 71111-4602
(318) 222-4299
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10
—
LA
Enumeration date
11/12/2015
Last updated
11/12/2015
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